UNIVERSITY OF PITTSBURGH FORM INSTRUCTION GUIDE 

FORM NUMBER:      FORM 0048 PITT 1801

FORM TITLE:            Parking Agreement

PROCEDURE:           04-03-01

EFFECTIVE DATE:   July 1997

PAGE (S):                   2

ENTER THE FOLLOWING INFORMATION WHERE INDICATED:

(Shaded areas are for Parking Office use only.)

1.    University parking lot abbreviation.

2.    Parking Permit number, if applicable.

3.    Key access card number, if applicable.

4.    ID number.

 

5.    Transaction Type: Check to indicate the purpose of the transaction (e.g. to initiate a

       parking agreement, terminate a parking agreement).

6.    Date the transaction is effective.

7.    Date the Parking Agreement was received by the Parking Office (to be entered by the

       Parking Office).

8.    Applicant's name: Last, First, MI (limit to 39 characters).

9.    Applicant's campus telephone number.

10.  Applicant's social security number.

11.  Applicant's campus address, room number, and building (see SPI 9).

12.  School/Responsibility Center.

13.  Department name.

14.  University account number if method of payment is an interdepartmental charge.

_________________________________________________________________________

Enter the following information for all vehicles the applicant intends to park using the

University Parking Permit:

15.  License plate number of vehicle.

16.  State of vehicle registration.

17.  Vehicle make.

18.  Wait list lot/garage request.

_________________________________________________________________________

For Payroll Deduction Only:

19.  Social security number of applicant.

20.  Payroll deduction code.

21.  Check to indicate paycheck frequency (biweekly or monthly).

22.  Dollar amount of payroll deduction.

23.  Effective date of payroll deduction start.

24.  Effective date of payroll deduction termination.

25.  Signature of applicant and date.

26.  Signature of Parking Representative and date.